In a study of renal biopsies in patients with DKD and animal models of DKD, it was found that interaction of the Notch signaling pathway with the NF-κB signaling pathway in macrophages promoted polarization of the macrophages and exacerbated the inflammatory response, fibrosis, and necrosis of the intrinsic cells in the kidneys. This evidence concerns the gene NFKB1 and diabetic kidney disease.